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withdrawal

Alcohol withdrawal takes place when someone abstains or significantly lowers the dose they drink after a period of excessive drinking.

The amount of alcohol regularly consumed will have a direct relation to how badly the withdrawal affects their body. Alcohol has a way of inhibiting neurotransmitters.

For example, it is known to inhibit the effect of GABA receptors in the brain which play a part in transmitting information between neurons in the brain.

The body tries to adapt to having suppressed responses, and alcohol becomes necessary in keeping GABA receptors working correctly.

When alcohol intake is stopped or lessened significantly, then the neurotransmitters work overtime to make up for an inhibited effect that is no longer there.

This can lead to seizures. Other body systems are similarly affected, leading to the various physical and mental symptoms of withdrawal.

Symptoms of Alcohol Withdrawal

The type, severity, and length of alcohol withdrawal symptoms will depend on several factors, including general health, how long alcohol was abused, and whether it is part of a dual diagnosis.

They can begin within mere hours of abstaining or lowering alcohol intake. Mental and physical signs may start immediately or after a delayed period depending on multiple factors.

Psychological Signs and Symptoms

The intensity of symptoms will vary, and some individuals may exhibit all of them while others only show a few.

Length of substance abuse and the amount of alcohol regularly consumed is the most significant contributing factor for the degree of symptom severity.

Below are the most common signs of alcohol withdrawal, some are only seen in severe cases.

  • Flu-like symptoms (e.g., headache, stomach ache, nausea, vomiting, sweating, fever, minor joint aches, exhaustion, etc.)
  • Mental confusion and trouble maintaining focus
  • Unusual sleep patterns (e.g., insomnia, vivid nightmares, etc.)
  • Changes in eating patterns (e.g., increase or decrease in appetite)
  • Anxiety and agitation
  • Shaking and body tremors
  • Hallucinations
  • Delirium tremens
  • Alcohol Craving
  • Unusual mood changes
  • Seizures

Medications to Combat Symptoms of Withdrawal

Medications are used to combat specific symptoms of withdrawal to make the pain and uncomfortableness easier to manage.

Since they can last for days or weeks, the prescribed medication will be altered to accommodate fluctuations during detox and extended withdrawal.

Since taking any medication can come with unexpected side effects and possible complications, they are usually reserved for the worst withdrawal symptoms.

For those going through mild withdrawal reactions, there might be anti-anxiety medications prescribed for the first few days and then discontinued.

Dangers of Going Through Detox Without Medical Intervention

Experiencing financial issue or feeling a sense of shame may make it difficult to reach out for help. These reasons and others can lead some people to attempt going through detox and withdrawal alone without professional healthcare intervention.

This includes a lack of prescribed medication. It is highly dangerous and can be life-threatening. There is a lot more to recovery than merely no longer drinking.

Mental and physical wellbeing need to be monitored and treated using methods that have been proven effective for long-term sobriety.

Common Medications For Alcohol Withdrawal

Anxiety, sleeping issues, seizures, hallucinations, and heightened blood pressure are a few of the things that a person might experience, and they can all be countered using specific medications.

Below a few prescribed drugs for treating alcohol withdrawal syndrome:

Non-benzodiazepine anticonvulsants are used for withdrawal and to counter alcohol dependency. Intense withdrawal is a high risk for people who have multiple instances of attempting to regain sobriety.

Every time someone goes through detox and rehabilitation, they have the potential to relapse, and then subsequent symptoms will generally increase in severity. This includes delirium tremens and seizures.

Here are a few standard anticonvulsants:

  • Gabapentin (e.g., Neurontin)
  • Carbamazepine (e.g., Tegretol)
  • Valproic Acid (e.g., Depakene)
  • Oxcarbazepine (e.g., Trileptal)

Benzodiazepines are used to help treat multiple withdrawal symptoms such as anxiety. They are also able to stabilize GABA receptors to lessen the effects of delirium tremens and seizures for anyone with severe withdrawal.

There are various ways that benzodiazepines can be administered including symptom triggered and fixed tapering doses. The doctor will determine which will fit best for the needs of the patient.

Below are commonly prescribed benzodiazepines for alcohol withdrawal syndrome:

  • Chlordiazepoxide (e.g., Librium)
  • Oxazepam (e.g., Serax)
  • Clorazepate (e.g., Tranxene)
  • Diazepam (e.g., Valium)

There will be specific medications if there are co-occurring medical disorders and various others for countering particular physical changes that may be uncomfortable but not necessarily dangerous.

They include meds like the following:

  • Antipsychotics (e.g., haloperidol)
  • This is prescribed if someone going through alcohol withdrawal also has a dual diagnosis of schizophrenia
  • Centrally Acting Alpha-2 Agonists (e.g., clonidine)
  • These will help counter high blood pressure, irritation, anxiety, and sweating
  • Barbiturates (e.g., Phenobarbital)
  • Used to help control seizures

Medication During Outpatient Treatments

Whether someone attends a residential facility or goes through outpatient treatment medications like benzodiazepines and anticonvulsants can be prescribed to help lessen the strain and stress of the withdrawal experience.

While being in outpatient care, there will be daily medical check-ups throughout the week to monitor any medication changes that need to take place.

If someone is only experiencing mild symptoms, they are usually encouraged to go through outpatient care as it is more affordable, and there is no need to wait for a treatment centre opening. For mild symptoms, there is also usually a shorter withdrawal period.

Stages of Alcohol Withdrawal Syndrome

There are multiple stages of withdrawal. They can begin as early as five to six hours after alcohol is cut off or diminished and will last for anywhere from a few days to several weeks.

Detoxing from alcohol should never be attempted without the supervision and care of a medical professional. It is essential to coordinate with a specialist or your doctor before you stop drinking or significantly lower how much you are drinking.

Withdrawal symptoms can range from mild to lethal, so it must be approached with caution.

The speed at which they unfold will be determined by multiple factors, including age, genetics, drinking habits, size, and gender. Not everyone will experience every stage; it will depend on the intensity of their withdrawal.

This stage usually begins within the first five to twelve hours and can include flu-like symptoms such as fever, shakiness, headache, nausea or vomiting, confusion, and heavy sweating.

For severe cases, there may also be high blood pressure and heart rate as well as rapid breathing. Further symptoms for this stage include those listed below.

Stage two begins after twelve to twenty-four hours and is characterized by the introduction of hallucinations (e.g., auditory, tactile, and visual). Some other symptoms you may see developing during this time include the following.

  • Insomnia or sleep disturbances
  • Delirium tremens

This is the period when seizures can begin though they can happen sooner in acute cases.

Most symptoms will abruptly worsen and then peak during this period, and it is one of the most dangerous times during withdrawal.

For people who are experiencing intense symptoms, it can lead to seizures or even death. Medical supervision is important during this period.

After a week the withdrawal will begin to lessen and then fade. However, there are still long-term disorders that might crop up due to withdrawal and last for months.

These include diagnosed anxiety disorders, depression, and the continued craving for alcohol. They all can be managed with prescribed medication.

Dangers of Abusing Prescription Drugs During Withdrawal

There are some dangers attached to taking medications during withdrawal.

They mostly stem from either abusing prescriptions, not following doctor instructions, or self-medicating as a way to cope with the detox and withdrawal.

These are dangerous and can lead to severe outcomes like coma and death.

Self-Medicating During Detox and Withdrawal

Many people self-medicate as a way to counter the awful way they feel when they go without drinking. This is incredibly common for anyone who is trying to get sober without medical intervention, and it is hazardous.

When someone uses medications that were prescribed for other reasons as a way to overcome withdrawal symptoms or if they get drugs off the street, then it can lead to serious adverse side effects.

It is more likely to fail and lead to relapse. Most people drink as a way of dealing with negative emotional states, and so they feel unable to cope when overwhelmed during withdrawal, so they turn to self-medication.

Prescription Abuse

One of the most common types of prescribed medication is benzodiazepines due to their calming effect.

Unfortunately, they are quite addictive and, especially when used long-term, the potential for risk for abusing them increases for people with certain anxiety disorders.

Over time it is possible to build up a tolerance, and so patients may increase their dose without consulting their doctor or use it past the time when they were instructed to stop.

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